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Many hospitals outsource radiological services, not only beyond their own institution, but outside the borders of the United States. These hospitals use teleradiology services to read and interpret diagnostic studies at night, when their regular radiologist is off duty. As digital technology enables the hospital to transmit the images anywhere around the world, this has led to the use of overseas radiologists to do interpretations. Currently, there are more than 20 companies through the United States that have reading rooms overseas in places like India, Israel, Australia and Hong Kong.
There are some obvious drawbacks to teleradiology, including the lack of communication between the clinician and the doctor reading the study, but it is also possible that the radiologists interpreting the study are not subject to the same credentialing requirements of the hospital’s real staff. Some radiology groups work around this issue by having the teleradiology service perform only the preliminary interpretation, and then one of the hospital’s regular staff follows up, oftentimes the following day, with a final official reading to confirm the diagnosis.
Most patients know and accept that hospitals commonly outsource certain laboratory tests to third parties, but few patients would think to question the source of the reading of a CT scan. Patients and family members in emergency situations are sometimes asked to make life-or-death decisions about treatment options in the middle of the night dependent upon the interpretation of a radiological study, but there is currently no requirement that hospital staff disclose to patients the location of the practitioner interpreting the radiology studies. Smaller hospitals and their patients can benefit from this practice, if it is done correctly and by a Pennsylvania-licensed radiologist who is affiliated directly with the institution where the patient is receiving care and meets the same credentialing requirements as the hospital’s radiology department staff physicians.
You can read more about this issue in this article or contact us with questions or to discuss a specific situation.